<form id="refuse-form" class="edit-form form-horizontal" role="form" data-toggle="validator" method="POST" action="">
    {:token()}
    <input type="hidden"  name="row[id]" value="{$row.id}">

    <div class="form-group">
        <label for="c-money" class="control-label col-xs-12 col-sm-2">剩余次数:</label>
        <div class="col-xs-12 col-sm-4">
            <input id="c-money"  class="form-control" name="row[money]" type="number" value="{$row.level_num|htmlentities}" disabled>
        </div>
    </div>


    <div class="form-group">
        <label for="c-money" class="control-label col-xs-12 col-sm-2">{:__('操作次数')}:</label>
        <div class="col-xs-12 col-sm-4">
            <input id="c-number"  data-rule="required" class="form-control" name="row[number]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <!--<label class="control-label col-xs-12 col-sm-2">{:__('Status')}:</label>-->
        <div class="col-xs-12 col-sm-8">
            {:build_radios('row[status]', ['normal'=>__('增加'), 'hidden'=>__('减少')], 'normal')}
        </div>
    </div>



    <div class="form-group">
        <label for="c-memo" class="control-label col-xs-12 col-sm-2">备注:</label>
        <div class="col-xs-12 col-sm-4">
            <input id="c-memo"  class="form-control" name="row[memo]" type="text" value="后台操作">
        </div>
    </div>


    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
